{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T14:24:12Z","timestamp":1793283852380,"version":"4.5.0"},"reference-count":21,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2023,5,17]],"date-time":"2023-05-17T00:00:00Z","timestamp":1684281600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>There is currently no consensus on proximal humerus fractures with an initial deformity in the coronal plane who are better off with plates or nails, so we designed this study. To compare the effect of the initial deformity in the coronal plane of proximal humerus fractures on postoperative outcomes, we compare the maintenance of reduction in procedures utilizing plates and nails, and analyzed the subsequent occurrence of complications to explore whether the initial deformity should dictate the fixation approach.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The clinical data of patients with proximal humerus fractures who were hospitalized and underwent surgical treatment in our hospital from January 2016 to December 2020 were reviewed. Postoperative functional scores (American Shoulder and Elbow Surgeons, ASES; Constant\u2010Murley Score, CMS), Neck\u2010shaft angle (NSA), Quality of fracture reduction, Deltoid Tuberosity Index (DTI), and complications were compared among cases with initial varus, normal, or valgus deformities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 131 patients, 56 males and 75 females, with a mean age of 60.89\u2009\u00b1\u20095.53\u2009years (range 50\u201376) and a mean follow\u2010up duration of 16.63\u2009\u00b1\u20096.78\u00a0months (range 12\u201348). Of these, 29 cases had initial varus displacement, 71 had a normal NSA, and 31 had initial valgus displacement. Seventy\u2010five were treated with a locking plate and 56 with a nail. After open reduction and internal fixation, the NSA was restored to normal (\u2212135\u00b0) in all patients in all groups (<jats:italic>P<\/jats:italic>\u2009&gt;\u20090.05). There was a significant difference in NSA changes at the last follow\u2010up; 2.93\u00b0\u2009\u00b1\u20092.12\u00b0 in the varus group, 1.77\u00b0\u2009\u00b1\u20091.18\u00b0 in the normal group, and 2.32\u00b0\u2009\u00b1\u20091.64\u00b0 in the valgus group, with the highest change occurring in the varus group. There was no significant difference in the range of motion or functional scores including ASES and CMS among the three groups (<jats:italic>P<\/jats:italic> &gt;\u20090.05). The complication rate of 20.7% in the varus group was significantly higher than the complication rates of 12.7% in the normal and 12.9% in the valgus groups (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>While proximal humerus fractures with initial coronal displacement (varus, normal, and valgus) show similar postoperative functional outcomes, varus fractures have a higher rate of complications. The nail provides better maintenance of reduction than the locking plate, especially in varus fractures.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.13690","type":"journal-article","created":{"date-parts":[[2023,5,18]],"date-time":"2023-05-18T06:31:49Z","timestamp":1684391509000},"page":"2074-2081","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Effect of the Initial Deformity in the Coronal Plane on Postoperative Outcome of Proximal Humeral Fractures"],"prefix":"10.1111","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4261-7861","authenticated-orcid":false,"given":"Fei","family":"Dai","sequence":"first","affiliation":[{"name":"Sichuan Provincial Orthopaedics Hospital  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming","family":"Xiang","sequence":"additional","affiliation":[{"name":"Sichuan Provincial Orthopaedics Hospital  Chengdu 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